BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:                    SB 1408             
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          |AUTHOR:        |Allen                                          |
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          |VERSION:       |April 18, 2016                                 |
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          |HEARING DATE:  |April 27, 2016 |               |               |
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          |CONSULTANT:    |Reyes Diaz                                     |
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           SUBJECT  :  Tissue donation

           SUMMARY  :  Allows for the transplantation of any tissues into the body of  
          a person when the donor of the tissues is found reactive for  
          human immunodeficiency virus (HIV), as specified, and removes  
          penalties for tissue donors who are reactive to HIV, as  
          specified.
          
          Existing law:
          1)Prohibits the transfer of any tissues, as defined, into the  
            body of another person by means of transplantation, unless the  
            donor of the tissues has been screened and found nonreactive  
            for evidence of infection with HIV, agents of viral hepatitis  
            (HBV and HCV), human T lymphotropic virus (HTLV), and  
            syphilis, except as provided.

          2)Authorizes the transplantation of tissue from a donor who has  
            not been tested for specified infectious diseases or, with the  
            exception of HIV and HTLV, has been found reactive, if  
            specified conditions are satisfied, including obtaining  
            consent from an intended recipient or the recipient's family.  
            Defines "family" as a spouse, adult son or daughter, either  
            parent, adult brother or sister, or grandparent.
          
          This bill:
          1)Allows for the transplantation of any tissues into the body of  
            a person when the donor of the tissues is found reactive for  
            HIV, if both of the following conditions are satisfied:

                  a)        The physician and surgeon performing the  
                    transplantation has determined any one or more of the  
                    following: i) without the transplantation, the  
                    intended recipient will most likely die during the  







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                    period of time necessary to obtain other tissue or to  
                    conduct required tests; ii) the intended recipient  
                    already is diagnosed with the infectious disease for  
                    which the donor has tested positive; or iii) the  
                    symptoms from the infectious disease for which the  
                    donor has tested positive will most likely not appear  
                    during the intended recipient's likely lifespan after  
                    transplantation with the tissue or may be treated  
                    prophylactically if they do appear; and, 
                  b)        Consent for the use of the tissue has been  
                    obtained from the recipient, if possible, or if not  
                    possible, from a member of the recipient's family or  
                    the recipient's legal guardian.

          2)Removes specified penalties for the donation of blood, body  
            organs, or other tissues by a person who knows that he or she  
            has tested reactive to HIV, or for a person afflicted with any  
            contagious, infectious, or communicable disease who willfully  
            exposes himself or herself to another person, for sperm  
            donors, as specified, and donors included in 1) above.

           FISCAL  
          EFFECT  : This bill is keyed non-fiscal.
           
          COMMENTS  :
          1)Author's statement. According to the author, this bill would  
            greatly improve the life expectancies of people living with  
            HIV who need organ or tissue transplants by removing  
            California's prohibition on donating organs or tissue while  
            HIV-positive. Under current state law, it is illegal for an  
            HIV-positive person to donate organs or tissues under any  
            circumstance. This existing law was enacted nearly 20 years  
            ago at a time when very little was known about HIV and AIDS.  
            Research made possible by the passage of the federal HIV Organ  
            Policy Equity (HOPE) Act of 2013 found that organ donations  
            from HIV-positive donors to HIV-positive recipients do not  
            have a detrimental effect. Major advances in the treatment of  
            HIV and AIDS mean that HIV-positive individuals are living  
            longer, and like other older Americans, they too are  
            developing medical conditions that require organ transplants.  
            However, the number of individuals in need of organ  
            transplants far exceeds the availability of healthy organs.  
            Increasing the number of eligible organ and tissue donors for  
            HIV-positive individuals will save lives.









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          2)Background. On November 21, 2013, President Obama issued a  
            statement that announced he signed the bipartisan-supported  
            HOPE Act, which allowed for scientists to carry out research  
            into organ donations from one person with HIV to another. As  
            noted in the statement, such organ transplants were deemed  
            illegal for decades. However, with growing effective  
            treatments for HIV and by signing the HOPE Act, successful  
            life-saving organ donations for people living with HIV could  
            eventually be realized. On November 22, 2013, Donate Life  
            California issued a statement applauding the President's  
            signing of the HOPE Act, stating that the change in policy had  
            the potential to save 1,000 HIV-infected transplant patients  
            each year, as well as shortening the list for uninfected  
            people awaiting transplants. 

            A March 30, 2016, article in the Los Angeles Times announced  
            the first organ transplantation from a deceased HIV-positive  
            donor to two HIV-positive recipients, performed by surgeons at  
            Johns Hopkins University Medical Center. Physicians involved  
            with the transplantation believe that many HIV-infected donors  
            are likely healthy enough to donate an organ without great  
            risk to their health. Also noted in the article is the  
            expectation that each year 500 to 600 HIV-positive people will  
            die under circumstances that would make their organs available  
            for transplant, which has the potential to make hundreds and  
            potentially thousands of transplantable organs available each  
            year to HIV-infected people with end-stage diseases of the  
            kidneys, heart, liver, and lungs.

          3)Support. The sponsors and other supporters argue that this  
            bill will bring state law into conformity with federal law,  
            ending a policy that was enacted at a time when very little  
            was known about HIV and AIDS. Supporters argue that with  
            advances in HIV understanding and treatment, HIV-positive  
            individuals are living longer and developing medical  
            conditions later in life for which organ transplants are the  
            standard of care treatment. Supporters state that this bill  
            will help alleviate waiting times on donor lists for all  
            people awaiting organ transplants, and that studies have shown  
            that transplants from one HIV-positive person to another do  
            not have a detrimental effect nor negatively affect patient  
            outcomes. 
          
          4)Technical amendment.  On page 6, line 6, strike out "of"









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           SUPPORT AND OPPOSITION  :
          Support:  AIDS Project Los Angeles (cosponsor)
                    Equality California (cosponsor)
                    Los Angeles LGBT Center (cosponsor)
                    Positive Women's Network-USA (cosponsor)
                    Access Support Network of San Luis Obispo and Monterey  
                    Counties
                    AIDS Healthcare Foundation
                    American Civil Liberties Union of California
                    Familia: Trans Queer Liberation Movement
                    Health Officers Association of California
                    Lambda Legal
                    Law Foundation of Silicon Valley
                    San Francisco AIDS Foundation
                    Two individuals
                    
          Oppose:   None received

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